فهرست مطالب zarch

In recent years, integration in medical education has been introduced as a prominent character in educational planning of universities of medical sciences. Presentation of disease-oriented specific pathology and pharmacology courses centered at the physiopathology, as examples of horizontal integration,is one of the educational goals of Shahid Sadoughi university of medical sciences. due attention to importance of the students’ opinions on success of this program, current study was conducted.
This descriptive-cross sectional research, was performed on medical students of Shahid Sadoughi University of medical sciences with using census, in 2013. Data were collected through a questionnaire, consisting of two parts of demographic information and questions in four sections; awareness and necessity of integration process (6 questions), education (9 questions), facilities (2 questions) and satisfaction from integration program (8 questions), using a Likert scale. Data was analyzed using descriptive statistics and SPSS software.
based on students viewpoints the highest scores rates have been devoted to section of education from integration plan (3.36 ± 0.45) then,the scope of satisfaction from integration process (3.26±0.4) and lowest points to the facilities (2.92 ± 0.7) is identified.
Considering the finding of this research, students of physiopathology courses had positive attitude toward presenting of pharmacology and pathology in integration method, But for improving the performance of this method, and upgrading laboratories facilities,it is necessary to cooperate with other groups in order to avoiding duplication of topics and also producing of manual description of the goals and plans of integration for students.

Ectopic pregnancy is a public health problem and their risk factors are unknown. This study was performed to identify risk factors for better diagnosis and treatment of this disease.
A case-control study on 195 cases of ectopic pregnancy (Case group) and 197 normal pregnancies (control group) were performed in Shahid Sadoughi and mother hospitals in Yazd city as representatives of public and private sectors. Cases of control group were pregnant women who entered immediately before and after the cases for delivery (normal or cesarean).
The mean age was 28.2±5.6, ranged from 14 to 45, and marriage age varied from 12 to 33 years. There was no significant difference between cases and controls according to body mass index (P=0.72). Inunivariate analysis, history of infertility (OR: 3.18, 95% CI= 1.9-5.2, P= 0.001), history of infections (OR: 1.67, 95% CI= 1.10-2.53, P= 0.01), use of intrauterine device (IUD) (OR:2.78, 95% CI= 1.08-7.16, P= 0.03) and tobacco smoking (OR: 2.96, 95% CI= 1.21-7.21, P= 0.01) were determined as risk factors for ectopic pregnancy.
This study demonstrates that history of infertility; use of IUD and oral contraceptive use are associated with ectopic pregnancy.

Stapes management in tympanosclerosis has always been controversial. There are evidences supporting stapes mobilization, but there are concerns regarding refixation and recurrence of conductive hearing loss; therefore, supporting stapedectomy. In this retrospective study, clinical records, operative notes, and audiologic data of patients with stapes fixation (1994–2011) were analyzed. Audiometric findings are reported according to the recommendations of the Committee on Hearing and Equilibrium 1995 Guidelines for the Evaluation of Results of Treatment of Conductive Hearing Loss. In the present study, 66 patients were enrolled (23 male, 43 female). Stapedectomy and stapes mobilization both had good hearing results (12.1 dB vs. 10.6 dB reduction in ABG) and there was no significant difference. Overall, 63.6% of patients had achieved good results (mobilization: 57.9%, stapedectomy: 71.4%). The difference in success rate between the two groups was not statistically significant. Stapedectomy and mobilization of stapes both seem to be efficacious and safe in the treatment of stapes involvement in tympanosclerosis. The hearing improvement is long lasting in both procedures.

Milk and dairy products for their quality and quantity of nutrients are the most basic nutritional substances for pregnant and lactating mothers and can best meet the needs of mothers and their fetuses. The aim of this study was to evaluate the knowledge, attitude and practice of mothers about milk and dairy products in the city of Yazd. This is a descriptive and cross-sectional study involving 254 pregnant women which was conducted in Yazd. Our data were collected by a researcher- made questionnaire based on demographic variables and questions about knowledge, attitude and practice. The data were analyzed by SPSS18, using descriptive and inferential tests. Mean of maternal age was 26.8 ± 4.98 years, and 50.8% of them were in their first pregnancy. The knowledge of 39.8% of the mothers about using the dairy was appropriate and the attitude of 13.8% of women in this area was good.Only practice of 6.3% of mothers in milk and dairy consumption was based on recommended values. There was no significant difference between milk consumption among pregnancy and non pregnancy condition of the participants. In addition, a significant relationship was found between the levels of their education and awareness. According to the findings, there was no significant correlation between their knowledge and attitude. The results of this study showed that mother's level of knowledge and attitude is moderate on milk and dairy products and pregnant women's consumption of them is less than the recommended minimum. Therefore, to improve the health of mothers and their children who make future of each society it is urgent to include promoting nutritional awareness of mothers especially on consumption of milk and dairy products.

The coarctation of the aorta (CoA) is rare in adulthood. Diagnosis is made by clinical suspicion and physical findings such as blood pressure difference between the upper and lower extremities, pulse delay in the femoral artery, and systolic murmur over the thoracic spine.The CoA in adulthood and in patients with associated aneurysm is challenging and different complications even with proper treatment can occur. Covered stents are indicated in concomitant aneurysm, older age, and tight coarctation. A 26-year-old male with resistant hypertension due to a CoA diagnosed by computed tomography angiography referred to our center for an attempted stent implantation. Cardiac catheterization and aortography revealed a long CoA after the origin of the left subclavian artery with a 60 mmHg gradient. Moreover, there was a large aneurysm in the site of the coarctation. Under general anesthesia and fluoroscopic guidance, two balloon-expandable covered Cheatham-Platinum stents (size 18 in 44 millimeters and size 18 in 50 millimeters) were successfully implanted across the CoA with no residual gradient. On 2 years'' follow-up, the patient had no symptoms except for mild hypertension. In this patient, the use of a covered stent within the aneurysm was safe and effective.

Diagnosing the necessity of cavity preparation and restoration in demineralized proximal areas is always considered as a challenge in restorative treatment planning. The purpose of this study was to assess the performance of the laser fluorescence (LF) technique in detection of proximal cavities. In this clinical trial, 44 proximal surfaces in 38 dental students were evaluated. The selected patients had radiolucent proximal lesions restricted to inner half of enamel or outer third of dentine in bitewing radiographs (BW). DIAGNOdent pen (LF pen) device was used to determine the presence or absence of caries cavities in suspected proximal surfaces. Orthodontic elastic separators were then placed in the contact areas to provide enough space for direct visual and tactile examination. The sensitivity, specificity and accuracy of the laser fluorescence technique were calculated versus the reference standard. The ROC curve was drawn and the best cut-off to determine the presence or absence of proximal cavities was determined. Using DIAGNOdent pen, the optimal cut-off for detecting proximal cavities was 18. The sensitivity, specificity and accuracy of DIAGNOdent pen for diagnosing proximal caries cavities were 100 per cent, 97.3 per cent and 97.7 per cent, respectively. Due to the high diagnostic accuracy of DIAGNOdent pen in detecting proximal caries cavities, it can be used as a valuable supplement in restorative treatment planning.

We describe the case of a man incidentally found to have a pseudoaneurysm of the ascending aorta at the site of a previously (12 years ago) implanted metallic prosthetic aortic valve. Transthoracic echocardiography and computed tomography images demonstrate the pseudoaneurysm. The patient has undergone surgical repair with a good result.

Case Report: Variant angina (VA), first described by Prinzmetal in 1959, is caused by transient and recurrent coronary spasm and leads to repetitive episodes of transmural myocardial ischemia. A 59-year-old man with a history of hyperlipidemia and anterior myocardial infarction, which had occurred three months previously and was being treated with fibrinolytics, referred to our hospital with acute substernal chest pain and ST elevation in the anterior leads. Coronary angiography showed coronary spasm, and the patient was relieved after nitrate administration. (Iranian Heart Journal 2012; 13 (2):62-64).

Case Report: Severe aortic valve insufficiency is a common valvular heart disease that is characterized by left ventricular (LV) volume overload. A 40-year-old woman with a history of exertional dyspnea of four years'' duration was referred to us for evaluation. The patient''s symptoms had worsened to NYHA functional class III in the previous months. Catheterization showed severe aortic insufficiency (AI) and normal coronary arteries, but there was aneurysmal outpouching formation in the base of the LV, into which the regurgitation jet did not enter directly. The patient underwent cardiac magnetic resonance imaging (CMR), which clearly showed that the AI jet entered the LV aneurysm. CMR is now an established tool to assess aortic regurgitation and to rule out concurrent pathologies. Determination of the anatomical configuration of the aortic valve is another great merit of preoperative evaluation with CMR compared to echocardiography alone. (Iranian Heart Journal 2012; 13 (2):59-61).

Obesity is a common public health problem reaching epidemic proportions in recent decades. Increased BMI imposes a pro- inflammatory state, releasing factors such as high sensitivity-C reactive protein which is strongly associated with plaque rupture and acute cardiovascular events. Also the prevalence of type 2 diabetes has reached epidemic level. A total of 400 consecutive patients recruited in this cross sectional study from April 2009 to December 2009 who was candidate for coronary angiography. Baseline clinical characteristics and coronary angiography data collected. Data analysis performed using 2-sided independent-sample t-tests. Out of 400 patients recruited in the study 253 were male. Obesity and diabetes observed in 65.7% and 32.5% of these patients respectively. Hypertension was more prevalent in obese patients (p=0.013) while dyslipidemia was not significantly different. The severity of coronary artery lesions were significantly associated with diabetes but not related to obesity (pvalue=0.0001 and 0.316 respectively). The main finding of this preliminary study was that diabetes is significantly related to severity of coronary artery disease and hypertension and hyperlipidemia is more prevalent in diabetic patients. Moreover, obesity is not significantly related to severity of coronary artery lesions